Demands and Needs Statement for the Nanny Policy

Morton Michel does not make recommendations or provide advice. The Nanny policy has been designed to meet the demands and needs of Nanny but you will need to make your own choice as to how you wish to proceed.

NannyInsurance for Nannies, Doulas, Maternity Nurses andChildminders exempt from compulsory registration

Arranged by

www.mortonmichel.com

Summary, Guide and Proposal

Nanny

Nanny is for qualified or experienced nannies,doulas and maternity nurses, who care for achild or children aged 0 - 17 and/or pre- andpost-natal mothers, based in the child’s ormother’s own home. It is also for childmindersexempt from compulsory registration who arethose that care for children aged over 8 only oraged 0-8 for less than 2 hours a day from thecarer’s own home.

Cover is not restricted to the home. It alsoapplies if you, as part of your role, take thechildren in your care out on trips, to the shopsor to play in the park - anywhere within the UK.

Nanny is provided by leading childcareinsurance specialist, Morton Michel, whichmeans you can be sure you have the right coverat the right price, with no hidden extra costs.

Making the right choiceWith Nanny insurance you know you have the rightlevel of cover supplied by a truly dependableinsurance provider and because insurance is ourbusiness, we have the professional expertise togive you true piece of mind.

Morton Michel is the leading childcare insurancespecialist. We pride ourselves on our speed andefficiency, with same day turnaround forprocessing most policies and a rapid response toclaims. We believe our service is second to none.Together with Sterling Insurance Company Limited,we have designed and written this specialist Nannypolicy to match your specific needs, providing theright level of cover at a competitive cost.

Value for moneyFrom just £59, your Nanny policy will cover you for:

• public liability

• legal expenses

• helplines for tax, legal matters, household repair support,medical advice and counselling

More details of the cover can be found on pages 4 and 5 which give a summary of the policy.

2

3

NannyInsurance for Nannies, Doulas, Maternity Nurses and Childminders exempt from compulsory registration

Arranged by

www.mortonmichel.com

Summary, Guide and Proposal

Arranged by

www.mortonmichel.com

NannyInsurance for Nannies, Doulas, Maternity Nurses and

Childminders exempt from compulsory registration

Policy

Easy to understanddocumentationWe supply you with this clear, easy-to-read policysummary of your insurance so you know what you arecovered for before you purchase your insurance andthen we supply you with full policy documentationwhen you take out your cover.

Plus... The MortonMichel ChildCare ClubInsure with Morton Michel to recieve FREE entryto the ChildCare Club, giving you a whole worldof fantastic extra benefits:

• Creative Minds digital magazine – packedfull of inspirational and creative ideas foractive young minds

• ChildCarer e-newsletter – monthly e-newsletter keeping you up-to-date with newsand views from the childcare sector. Monthlydraw – great childcare related prizes to bewon!

• FREE EYFS Training Guides – designed tosupport childcarers who wish to update theirEYFS knowledge and help them successfullyimplement the Early Years Foundation Stage.

• Amazing discounts for trips to LegolandWindsor, Legoland Discovery Centre,Chessington World of Adventures and SeaLife centres.

• Great discounts to many of the UK’s topindoor soft play centres. They are all insuredby Morton Michel so you know that they arecorrectly covered.

• Fantastic discounts on Beaches Resorts bySandals holidays. Choose from fourspectacular locations in Turks & Caicos andJamaica.

• Generous discounts from selected suppliersto the early years and childcare sector suchas Activ Kids, Blue Butterfly Flooring,Puppets by Post, Yellow Door, TheConsortium Early Years, Halfords, TidyBooks, Leaps and Bounds, FingershieldSafety UK and The Childcare Company.

• Subscription discounts to main early yearsand childcare magazines such as NurseryWorld, Early Years Educator, Practical Pre-School, Creative Steps, EssentialChildminder and Nursery ManagementToday.

Visitwww.mortonmichel.com/childcareclubfor further information on theseexciting benefits.

Public Liability Insurance

Limit of Indemnity £3,000,000(Higher limits available on request)

If, as a nanny, doula, maternity nurse or childminderexempt from compulsory registration, you are heldlegally responsible for an injury (including death) toa child or third party, or for damage to a third party’sproperty, then you will be required to pay damages.Public Liability insurance covers these damages andany resulting legal expenses, up to the limit ofindemnity.

Automatically Included

• attendance at exhibitions, creches, meetingsand outings run for and on behalf of home-based childcare professionals

• food poisoning

• incorrectly administered first aid treatment

• administration of medicines and drugs inaccordance with policy conditions

• administration/provision of oxygen, gastrofeeding, naso-gastric tube feeding, cleaning andchanging of feeding and tracheostomy/tracheotomy tubes and emptying/changingstoma bags in accordance with policy conditions

• children with special needs

• use of trampolines, climbing frames, bouncycastles and garden swimming pools inaccordance with policy conditions

• duties in relation to your home-based childcarebusiness, outside UK, for holidays and the like,for a maximum of 180 days in countries of theEuropean Union and a maximum of 90 daysanywhere in the world (unless you are travellingagainst advice from the Foreign Office of theBritish Government)

• providing babysitting services in accordancewith policy conditions

• contingency motor liability - this does not replace

or include ordinary motor insurance and it doesnot cover the motor vehicle or its contents. It doesprovide cover if you use someone else’s vehicle(with their permission) in relation to your home-based childcare business and a motor accidentoccurs for which you are legally responsible, butthe vehicle owner does not have the necessarybusiness cover in place. However, you must takeall reasonable precautions to ensure that anyvehicle used has the appropriate motor insurance.

Territorial Limits

• anywhere in Great Britain, Northern Ireland, theIsle of Man or the Channel Islands.

Main Exclusions

• liability for accidental bodily injury to any mindedchild not in your direct and immediate personalcare, custody or control (except in an emergency)

• liability arising from the actions or omissions ofany employee, assistant or helper (except inrespect of accidental bodily injury to a mindedchild left in their care in an emergency)

• property belonging to you or your family or youremployer(s) or in your custody or control

• liability which should be covered under youremployer’s household policy

• any bodily injury to you, any member of yourfamily or person employed by you

• liability arising out of asbestos or its derivative

• terrorism, war and similar risks

• fines, penalties or liquidated, punitive orexemplary damages

• treatment (other than first aid treatment, theadministration of drugs/medicines in accordancewith policy conditions and the administration/provision of oxygen, gastro feeding, naso-gastrictube feeding, cleaning and changing of feedingand tracheostomy/ tracheotomy tubes andemptying/changing stoma bags in accordance

with policy conditions).

The Nanny policy is underwritten by Sterling Insurance Company Limited (except where otherwise stated).

This document summarises the cover provided by the Nanny policy and should be read carefully beforeyou complete the proposal form. The Policy Summary does not contain the full terms and conditions,which can be found in the policy document. A full policy document is available free of charge fromMorton Michel.

4

Policy Summary

Legal Expenses

Limit £50,000 any one eventCover, which is provided by DAS Legal ExpensesInsurance Company Limited (DAS), will pay your legalcosts including solicitors’ and barristers’ fees, courtcosts, expenses for expert witnesses, attendanceexpenses and accountants’ fees.

Automatically Included

• a legal representative to support you if you areasked to go to the police station for a matterrelating to your work as a nanny, doula,maternity nurse or childminder exempt fromcompulsory registration

• legal defence in the event of a criminalprosecution arising from your business activitysuch as alleged child abuse of the child/childrenin your care

• taxation disputes with HM Revenue and Customs

• support for contract disputes of over £100, if aparent breaks with your contract terms

• support for the recovery of a debt of over £100, ifa parent fails to pay for your services.

• DAS will negotiate for your legal rights in adispute arising from your contract ofemployment as a nanny, doula, maternity nurseor unregistered childminder.

Main Exclusions

• costs and expenses incurred before the writtenacceptance of a claim by DAS

• costs and expenses in connection with acontract dispute or debt under an agreemententered into prior to the inception of thissection, if the dispute arises or if the debt is duewithin the first 90 days of this sectioncommencing

• employment disputes arising in connection withemployer’s disciplinary hearings, internalgrievance procedures or compromise agreementwhile you are still employed

• any civil claim which does not offer a reasonableprospect of success.

Optional Extras

Your Nanny policy may be extended to includePersonal Possessions insurance.

Personal Possessions

If you have accommodation at your employer’s home,Morton Michel offers an “all risks” insurance to coveryour household goods and personal effects, whilstcontained in your employer’s home. Sum insured£3,000 (higher amounts available on request).

Helplines

Helplines, provided by DAS, are automaticallyincluded with your policy to give professionaladvice and support. They are available 24 hoursa day, 365 days of the year.

Advice is given on:

• Tax: including VAT, self-assessment, incometax and HM Revenue & Customs audits.

• Legal matters: including employment andcontract disputes.

• Health and medical information: includingfood allergies, medication, childhoodillnesses, vaccinations, nutrition and exercise.

Help is provided through:

• Emergency repair support: giving access toapproved contractors for plumbing,electrical, gas and roofing repairs (you willbe responsible for the cost of the repair).

• Confidential counselling: a valuable supportservice to help you through those difficulttimes whether because of stress, anxiety,depression, relationships, bereavement orhealth related. It includes onwards referralto relevant voluntary and/or professionalservices, where appropriate.

5

Helplines

More from Morton Michel

Main Exclusions

• the first £50 of each claim

• damage caused by rot, fungus, insects, vermin,pests, pets

• terrorism, war and similar risks.

As well as Nanny insurance, we have otherinsurances that we have developed especially tosupport you as a home-based childcareprofessional.

Household InsuranceIf you live in, your Nanny policy offers an OptionalSection to cover your Personal Possessions whilstin your employer’s home.

If you live out, we can arrange full HouseholdContents insurance for you.

For more details please call freephone:

0800 975 4898.

Motor InsuranceIf you carry children in your car, you must makesure that you have adequate motor insurance coverin place. Some insurers will charge an additionalpremium for this. Morton Michel’s motor policyautomatically allows you to use your car inconnection with your childcare business at noextra cost. We believe that it is the only motorpolicy to specifically state on your certificate ofinsurance that you are covered for: “social,domestic, pleasure and business use in connectionwith childcare activities”.

For details of our competitively priced motorcover, please call freephone:

0800 975 4898.

Morton Michel - The ChildcareInsurance SpecialistFounded in 1964, Morton Michel is a recognisedleader in childcare insurance. It has unrivalledexpertise in this field, which it applies to thedevelopment of its insurance products.

Morton Michel arranges cover for around 10,000nurseries and preschools, 20,000 childmindersand nannies, 6,000 out of school clubs andnumerous other social and voluntary groupsconnected with childcare.

Morton Michel is dedicated to providing top qualityservice to all its clients. It does not use call centresso you will speak directly with a person involved inorganising your insurance, who can discuss anyaspect of the Nanny policy.

Sterling Insurance Company Limited

Sterling Insurance Company Limited offers anextensive range of commercial and personalinsurances.

Established over 50 years ago, Sterling isparticularly renowned for its specialist policies,such as Nanny, which meet the needs of specificbusinesses or services. The Company prides itselfon its efficient use of the latest technology in theadministration of its policies and in the swiftsettlement of claims.

Sterling has worked closely with Morton Michelfor over forty years and continues to do so today,underwriting Morton Michel’s specialist childcarepolicies. Together, their extensive experience ofthe childcare industry enables them to developpolicies that match the specific risks involved.This results in comprehensive cover atcompetitive premiums.

6

Frequently Asked Questions

Why do I need public liability insurance?

Public liability insurance covers you for anythingthat may happen to the children in your care forwhich you can be held legally liable. It could besomething as simple as a child being scalded by ahot drink left within reach, or it could be a babywriggling and falling off a changing table, or atoddler choking on something they should nothave had access too. If you are considered to benegligent at the time the accident happened, youcould find yourself having to pay damages for anyinjuries sustained.

Am I able to apply for my insurance online?

Yes, you are able to apply for your Nanny insurancevia our secure site www.mortonmichel.com

What are the Ofsted Voluntary Register, theVoluntary part of the Childcare Approval Scheme(CAS) and the Social Care and Social WorkImprovement Scotland (SCSWIS) approvedbodies?

Nannies, Maternity Nurses, Doulas andChildminders who care for children over the age of8 only have not previously required registration.However they are now able to register under thevoluntary part of the Childcare Register in England,the voluntary part of the Childcare ApprovalSystem (CAS) in Wales or through SCSWISapproved bodies in Scotland. These schemes offerthe choice of registration to providers who are noteligible for compulsory registration. By joining thevoluntary register, providers show parents who usetheir services that they meet certain requirementsdesigned to safeguard children and are monitoredthrough inspections. Parents who use registeredchildcarers may be eligible to claim the childcareelement of working tax credit.

Childcarers who are registered are entitled to adiscount off their Nanny insurance premium.

How many children am I covered for?

The number of minded children in your direct andimmediate personal care at any one time must notexceed six.Am I covered if I take the children on outings?

Yes, the Nanny policy will cover you anywherewithin the UK - whilst carrying out your activities asa home-based childcare professional.

Am I covered in a nanny share arrangement?

Nanny share situations are automatically covered,provided you are within any Ofsted / otherregistering authority rulings on the number ofchildren you take care of and any registrationrequirements.

Am I covered if I nanny abroad with myemployers’ family?

Our Nanny policy will cover you to mind childrenanywhere in the world, for a maximum period of 90days in any one period of insurance, and tocountries in the European Union for a maximumperiod of 180 days in any one period of insurance.However, the children being minded by you abroadmust be the minded children you are employed tolook after in the UK, at least one parent of theminded children must be on the trip with you, youmust have travel insurance for the completeduration of the trip and you must not be travellingagainst advice from the British GovernmentForeign Office.

Will I receive a policy document telling meexactly what I’m covered for?

Yes. When you take out a Nanny policy with MortonMichel you will receive a Schedule of Insurancedetailing your cover limits and a policy bookletdetailing all the policy cover and conditions so youcan refer to them at any time. This gives you thepeace of mind of knowing exactly what you arecovered for.

7

Supposing a child has an accident during theperiod of my insurance policy but does not bringa claim against me until months or years later,when I no longer have a policy in force. Will Istill be covered?

By law, a claim can be brought against a childcareprofessional up to a child’s 21st birthday - longafter they have left your care. Our insurance willcover you if you had a policy in place at the time ofthe accident and are legally liable for the accident.Some other companies only offer policies thatcover you during the time that you are paying forthe insurance so, as soon as you stop paying, sodoes the cover. However, any incident that couldresult in a claim being made should be reported toMorton Michel.

Am I covered for taking minded children in my car?

Your Nanny policy will not cover you for using yourcar in connection with your childcare business. Youwill need to check with your current motor insurersto arrange adequate cover.

Our motor policy is specially designed to cover youin connection with your nanny business. If youwould like a quotation please call freephone 0800975 4898.

So, what is contingent motor liability?

Contingency motor liability does not replace yourordinary motor insurance and it does not cover themotor vehicle or its contents. It provides cover ifyou use someone else’s vehicle (with theirpermission) in relation to your home-basedchildcare business and a motor accident occurs forwhich you are legally responsible, but the vehicleowner does not have the necessary business coverin place. However, you must take all reasonableprecautions to ensure that any vehicle used hasappropriate motor insurance.

Do my employers need their own insurance forme to work in their home?

Yes, your employing family should have their ownEmployers’ Liability cover to cover them if yousustain an injury in their home as a result of theirnegligence. However, this is something that isnormally added on to a Household Contents policyso, in the first instance they should contact theircurrent insurers. If they are unable to extend theircurrent policy then Morton Michel offer aHousehold cover for families employing home-based childcare professionals, call freephone0800 975 4898 for further information.

Am I covered if I provide babysitting services?Yes, you are covered to mind up to six children intheir own home at any one time, providing youcomply with the following policy conditions:i) you must have a note of the parent’s contact

details;ii) you must visit the home(s) where you are to

babysit beforehand, identify any associatedrisks, advise the parent of any such risks inwriting and take/recommend any appropriateaction;

iii) you must obtain the medical details andpermissions for emergency treatment in respectof each child to be looked after;

iv) you must obtain the parent’s signatureconfirming the above information.

8

Customer Service Information

1. Sterling Insurance Company Limited

Sterling Insurance Company Limited is a privatecompany limited by shares, registered in Englandand Wales number 498605. It underwrites generalinsurance business. It is authorised and regulatedby the Financial Services Authority (FSA). The FSAis the independent watchdog that regulatesfinancial services.

Our FSA Register number is 202012. You can checkthis on the FSA’s Register by visiting the FSA’swebsite

www.fsa.gov.uk/register or by contacting the FSAon 0845 606 1234.

Sterling Insurance Company Limited is a memberof Sterling Insurance Group Limited.

Registered Office:Ambassador HouseParadise RoadRichmond upon ThamesSurrey TW9 1SQ

Branch Office:50 Kings Hill AvenueKings HillWest MallingKent ME19 4JX

2. Disability Discrimination Act 1995

In accordance with the Disability DiscriminationAct 1995 we are able to provide upon request atextphone facility, audio tapes, large printdocumentation and braille documentation. Pleaseadvise us if you require any of these services to beprovided so that we can communicate in anappropriate manner.

3. Law applicable to the contract

We propose to choose English law as the lawapplicable to the contract unless we agree anotherchoice of law with you prior to the start date.

4. Premiums

Premiums are payable annually to Morton Michel.Insurance premium tax, as imposed by currentlegislation, is incorporated into all premiums.

5. Promise of satisfaction and service

We are confident that your Nanny policy will bringyou complete satisfaction. We undertake to refundthe premium in full if you are not satisfied with

the cover provided by your policy if it is returnedwithin 14 days of issue, but if there has been anincident which has resulted or could result in aclaim you must reimburse the Company for anyamounts we have paid or may be required to pay,in respect of that incident.

6. Duration of contract

The first period of insurance under your Nannypolicy will be 12 months unless otherwiserequested by you and agreed by the Company.

7. Financial Services Compensation Scheme

We are covered by the Financial ServicesCompensation Scheme (FSCS). You may beentitled to compensation from the scheme if wecannot meet our obligations. This depends onthe type of business and the circumstances ofthe claim. Further information aboutcompensation scheme arrangements is availablefrom the FSCS.

8. Notification of a claim

If you have a claim, or are aware of an incidentthat could result in a claim, please contactMorton Michel on 0845 2570900 or SterlingInsurance Company Limited on 0845 271 1300.

9. Enquiries or complaints

If you have an enquiry or complaint regarding:• the suitability of this policy for your needs; or

• the information and advice you receivedwhilst it was originally being discussed; or

• the operation or administration of the policyor an enquiry concerning a claim that youmay have made; you should contact MortonMichel at Alhambra House, 9 St MichaelsRoad, Croydon CR9 3DD; telephone number0845 2570900.

If you have a complaint concerning a claim youhave made you should contact Sterling InsuranceCompany Limited, 50 Kings Hill Avenue, KingsHill, West Malling, Kent ME19 4JX; telephonenumber 0845 271 1300

(A copy of Sterling’s complaints handlingprocedure is available on request by writing tothe Customer Services Manager, SterlingInsurance Company Limited, 50 Kings HillAvenue, Kings Hill, West Malling, Kent ME19 4JXor by telephoning 0845 271 1300).

9

If your complaint relates to the Legal ExpensesCover, please write to The Customer RelationsDepartment, DAS Legal Expenses InsuranceCompany Limited, DAS House, Quay Side,Temple Back, Bristol BS1 6NH or telephone 0117934 0066 or emailcustomerrelations@das.co.uk.

Details of the DAS internal complaint-handlingprocedures are available on request

Please be ready to provide all relevant details ofyour policy and in particular your policy number(if allocated) to help your enquiry or complaintto be dealt with speedily.

If you are not satisfied with the way in whichyour complaint has been handled, you may havethe right to refer it to the Financial OmbudsmanService at South Quay Plaza, 183 Marsh Wall,London E14 9SR; telephone number 0845 0801800.

Please note that the Financial OmbudsmanService will normally only consider a complaintonce we have issued a final response letter.Nothing in the terms and conditions of this policywill reduce your statutory rights relating to faultyor mis-described goods or services. For furtherinformation about your statutory rights, youshould contact your local authority TradingStandards Department or Citizen’s Advice Bureau.

Following this procedure will not affect your legalrights.

10. Information about DAS Legal ExpensesInsurance Company Limited

DAS Legal Expenses Insurance Company Limited isa private company limited by shares incorporatedin England and Wales under registered number103274. It underwrites legal expenses business. Itshead and registered office is DAS House, QuaySide, Temple Back, Bristol, BS1 6NH. It isauthorised and regulated by the Financial ServicesAuthority and appears on the Financial ServicesAuthority’s register under number 202106.

11. Morton Michel

Morton Michel Limited is a private company limitedby shares incorporated in England and Walesunder registered number 5120835.Its Registered Office is 3rd Floor, Chancery House,St Nicholas Way, Sutton, Surrey, SM1 1JB; its headoffice is Alhambra House, 9 St Michaels Road,Croydon CR9 3DD.It is authorised and regulated by the FinancialServices Authority (FSA) and appears on theFinancial Services Authority’s register undernumber 527300. You can check this on the FSA’sRegister by visiting the FSA’s Website.

10

Important Notes

1. ‘Nanny’ is defined in the policy as a personcontracted and paid to look after a child(children) working in and from the child’shome.

2. ‘Doula’ is defined in the policy as a personcontracted and paid to provide a baby’smother with physical, emotional andinformational support in pre-natal care, duringchildbirth and during the post-partum period,working in the mother’s home.

3. ‘Maternity Nurse’ is defined in the policy as aperson contracted and paid to care for bothmother and baby during the post-partumperiod, working in the mother’s home.

4. ‘Childminder exempt from compulsoryregistration’ is defined in the policy as aperson contracted and paid to look after achild (children) aged over 8, or aged 0-8 forless than 2 hours a day, from the carer’s ownhome and who is exempt from compulsoryregistration.

5. The term ‘minded child’ when used in thispolicy relates to children for whom you arecontracted and paid to look after.

6. Nanny share situations are automaticallycovered, provided you are within anyOfsted/other registering authority rulings onthe number of children you take care of andany registration requirements.

7. If you are using either your own car or a carbelonging to any member of your family totransport minded children, you must makesure you have appropriate motor insurance tocover you. Please call us on freephone 0800975 4898 for a quote, if required.

11

Arranged by

www.mortonmichel.com KH2643 09.12

Tel: 0845 2570900 Fax: 0845 2570547/0548 www.mortonmichel.com

Morton Michel Alhambra House 9 St Michaels Road Croydon CR9 3DD

www.mortonmichel.com

Nanny Proposal FormPlease read the Summary and Guide carefully before you complete this form.Your insurance will be provided under a Nanny Policy. Any special terms or conditions will be advised to you in writing.Please complete and return together with your payment to Morton Michel, Alhambra House, 9 St Michaels Road, Croydon, CR9 3DD. You can take out this cover online if you preferby going to www.mortonmichel.com and following the links in the Nanny section. If you take out cover online, you do not need to complete and return this form.

Title Miss/Mrs/Ms/Mr/Other

Proposer’s name in full Date of Birth

Telephone No. Email address

Your address in full

Postcode

Address of premises where you work

Postcode

1. Do you work as:

a) a nanny? b) a doula? c) a maternity nurse? d) a childminder exempt from compulsory registration?

2. How many hours a week do you work?

3. How many children will you be looking after,

aged under 8? aged between 8 and 12? aged between 12 and 17?

4. Details of your qualifications

5. Details of your experience

6. Are you registered on, or have you applied to be registered on, the voluntary part of the Ofsted Childcare Register (England)?If YES,Date Registered (if already registered): Registration number (if allocated):

7. Are you on, or have you applied to be on, the Childcare Approval Scheme (Wales)?If YES,Date Approved (if already approved): Approval number (if allocated):

8. Are you, or have you applied to be, registered through a Social Care and Social Work Improvement Scotland (SCSWIS) approved body?If YES,Date Approved (if already approved): Approval number (if allocated):

9. Do you have a Criminal Records Bureau check or Disclosure check for working with children?

10. You are automatically covered for £3M Public Liability. Do you require the cover to be increased to £5M?(Additional Premium £30.00 including IPT)

11. Have you been convicted of any criminal offence (other than motoring offences) or is any prosecution pending?

12. Has there ever been a claim (insured or otherwise) made against you in any childcare capacity?If you have answered YES to questions 10 or 11, please give full details

13. I require my Nanny insurance to commence from

14. a) Do you have any existing insurances with Morton Michel?If YES, please state policy number(s)

b) Have you had any previous insurances with Morton Michel?If YES, please state policy number(s)

Optional ExtraPersonal Possessions (for live-in nannies). For details of what is included, please see Summary and Guide. If you require Personal Possessions insurance, please complete the following:

1. Is sum insured of £3,000 adequate?

If NO, what is the full value of your Personal Possessions at your employer’s home?

£4,000 £5,000 £6,000 £7,000 If more than £7,000, please state amount for a quotation £

2. Is the total value of jewellery, watches, furs, silverware, antique furniture, articles of precious metal and precious stones more than £2,000?

3. Is the value of any single article, pair, set or collection more than £1,000?

4. Have you suffered any loss or damage to your personal possessions in the last 5 years?

5. Have you ever had an insurance proposal or renewal declined or special terms imposed(in relation to insurance of personal possessions)?

6. I require my Personal Possessions insurance to commence from:

If you have answered YES to questions 2, 3, 4 or 5, please give full details

Yes NoYes No Yes NoYes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Continued Overleaf

Nanny Proposal Form ContinuedDeclaration I declare that to the best of my knowledge and belief the answers given are true and complete in every respect. I agree that this proposal and declaration shall be thebasis of the contract between me and Sterling Insurance Company Limited and shall be deemed incorporated in such contract.

Data Protection Act I/we understand and agree that the personal information I/we provide (including sensitive personal details) may be used for insurance purposes by SterlingInsurance Company Limited, its connected companies, reinsurers, agents and subcontractors; and also shared with other insurance companies as required for the purposes ofmy/our insurance. Where we have provided information about my/our spouse(s), partner(s) or another person/other persons (including their sensitive personal details) I/weconfirm that I/we have their permission to provide this information for insurance purposes. I/we give irrevocable authorisation for any medical practitioner I/we have consulted toprovide any medical information requested by Sterling Insurance Company Limited and its connected companies, in relation to a claim made by my/our personal representatives inthe event of my death/our deaths. I/we understand that I am/we are entitled to a copy of my/our personal information on payment of a fee.

From time to time, Morton Michel may wish to send you details of services and products, if you do not wish to receive such mailings, please tick this box.

Signature Date

You have a duty to disclose all material facts and failure to do so could invalidate the insurance. Cover does not commence until the proposal has been formally accepted byMorton Michel unless otherwise agreed with Morton Michel.

How would you like your documentation sent to you?

Sending documents in pdf format by email is quicker and kinder to the environment. It also means that you can keep a copy on your computer to print out whenever required. Ifyou would prefer to have a pdf of your policy schedule and policy booklet sent to you by email instead of post, please tick the box below and provide your email address, clearlyprinted. If you do not tick the box or provide your email address then your documents will be sent by post.

Please email my documents to me My email address is:

Where did you hear about Morton Michel? (Please tick as appropriate)

Nanny Agency Friend Employer Ofsted Other (please state)

Childcare Motor InsuranceWould you like Morton Michel to provide a quotation?

Premium CalculationNanny £59.00 including IPT if you are working and domiciled in the UK other than Northern Ireland, the

Channel Islands and the Isle of Man AND are registered on, or have applied to be registered on, thevoluntary part of the Ofsted Childcare Register (England) or the Childcare Approval Scheme (Wales)or through a Social Care and Social Work Improvement Scotland approved body (Scotland). £

£70.00 including IPT if you are not registered as stated above. £

£80.00 including IPT if you are working and domiciled in Northern Ireland. £

£66.04 (nil IPT) if you are working and domiciled in the Channel Islands or the Isle of Man. £

Optional Extras (Please tick level required)

Increase Public Liability to £5MAdditional Premium £30.00 (including IPT) £

Personal Possessions(Please complete proposal form overleaf, if PersonalPossessions insurance is required.)

Level Premium (including IPT)

£3,000 £30.00 £

£4,000 £40.00 £

£5,000 £50.00 £

£6,000 £60.00 £

£7,000 £70.00 £

Total Premium £

Morton Michel Administration Fee £ 1.00

Total to pay £

I have enclosed a cheque or credit/debit card details or a completed direct debit mandate as payment for the above Nanny insurance and any selected optional extras.

Payment by Credit/Debit Card: Please complete the form below

Cardholder’s Name

Cardholder’s Address

Postcode

Card Number

Security Code Issue Number (switch / solo only)

Expiry Date Valid From

Total Amount to be charged £

Signed

Yes No

Underwritten by Sterling Insurance Company Limited. Registered in England and Wales No. 498605 Registered Office: Ambassador House, Paradise Road, Richmond-upon-Thames, Surrey TW9 1SQAuthorised and Regulated by the Financial Services Authority.